C09979386 / invoice 10000

CH - Licking paw, otherwsie well

Patient Presented for:

History: 
licking one paw 
looks like maybe focusing on dew claw 
started few weeks ago - hasn't drastically worsened 

RFL worse, LFL also slightly stained though 
no lameness, doesn't seem sore - walking well 
no known injury 

no recent dietary change 
no grass seeds in yard - but did go to farm weeks ago  

Clinical Exam: 
BAR
MM pink, CRT 1-2sec, minimal calculus - teeth good
Abdo palp S+C
Chest clear, no murmur or arrhythmia
BT not taken
Both FL - mild salivary staining medial aspect of paws. 3rd digit RFL - mild inflammation around nail bed. No palpable swellings, no wounds or draining tracts evident. Matt of fur between digits 3&4 RFL. 

Differential Diagnosis: 

Test Results: 
cytology sticky tape prep RFL dew claw and 3rd digit nail bed - yeast + 

Definitive Diagnosis: malasezzia infection - likely secondary (allergies? pain? anxiety? paronychia? neoplasia?) 

Plan:
Pred 5mg PO SID for 5 days then 2.5mg SID for 5 days then EOD for 5 days 
Malaseb bathing both FLs for 3wks 
Revisit in 3wks - INI or if deteriorating - investigate underlying cause 



Pet insurance - Y/N
Is this a Gaponly Claim- Y/N